QAI Medical Economics Analyst II

CareSource

1d

About The Position

The Medical Economics Analyst II is responsible for analyzing healthcare utilization to identify patterns, variation, and outliers as well as identify and quantify opportunities to reduce medical costs. Essential Functions: Identify, quantify and model opportunities to reduce medical costs within the markets Evaluate the effectiveness of medical cost reduction initiatives Understand and calculate basic healthcare KPI’s Complete analytic process from start to finish and provide recommendations on medical cost savings initiatives Analyze healthcare utilization to identify patterns, variation, and outliers Develop tools to efficiently compare market performance across and within products Monitor the efficiency and efficacy of clinical programs, interventions and processes Support the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organization Identify the variables and methodologies (e.g., qualitative, quantitative, spatial) that define population cohorts that can be positively impacted through targeted programs and interventions Produce and maintain quarterly forecast projections for medical cost initiative reductions Perform any other job duties as requested

Requirements

• Bachelor’s Degree or equivalent years of relevant work experience is required
• Minimum of two (2) years of experience in healthcare analytics is required, health plan preferred
• Knowledge of healthcare data, including medical and pharmacy claims, EMR data, HIE data, UM data and demographic data
• Basic ability to analyze and interpret financial data in order to incorporate into analyses/reports
• Proficient in Excel (Power Query, Power Pivot), Word and PowerPoint
• Proficient with Transact-SQL or Microsoft Power BI
• Strong critical thinking skills
• Ability to organize data in a way that facilitates inferences, conclusions and decisions
• Demonstrated written and verbal communication skills

Nice To Haves

• Managed care experience is strongly preferred
• Knowledge of Medicaid, Medicare and other government sponsored healthcare programs is preferred

Responsibilities

• Identify, quantify and model opportunities to reduce medical costs within the markets
• Evaluate the effectiveness of medical cost reduction initiatives
• Understand and calculate basic healthcare KPI’s
• Complete analytic process from start to finish and provide recommendations on medical cost savings initiatives
• Analyze healthcare utilization to identify patterns, variation, and outliers
• Develop tools to efficiently compare market performance across and within products
• Monitor the efficiency and efficacy of clinical programs, interventions and processes
• Support the intake, prioritization and coordinated execution of ad-hoc analytics requests from departments across the organization
• Identify the variables and methodologies (e.g., qualitative, quantitative, spatial) that define population cohorts that can be positively impacted through targeted programs and interventions
• Produce and maintain quarterly forecast projections for medical cost initiative reductions
• Perform any other job duties as requested

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level